Amazon and friends try to heal the healers

Shift in thought

Amazon joins with Berkshire Hathaway and JPMorgan to bring the best in disruptive innovation to curbing costs in health care. Yet their approach needs a deeper look at quality of care.

Warren Buffett (l), chairman and CEO of Berkshire Hathaway, Jeff Bezos (m), CEO of Amazon.com, and Jamie Dimon, chairman and CEO of JP Morgan Chase are teaming up to create a health care company that is "free from profit-making incentives and constraints."

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The Monitor's Editorial Board

January 31, 2018
—One of Amazon’s “leadership principles” for its employees calls on them to keep “looking around corners for ways to serve customers.” Another one is to “not compromise for the sake of cohesion.”

Such creative approaches may help explain why the Seattle-based e-commerce giant has decided to join forces with two other big companies and disrupt an industry that commands a fifth of the American economy: health care.

The health-care industry has long been considered “too big to disrupt” with the kind of innovation that, say, has transformed retail (Amazon), urban travel (Uber) or commercial flying (Southwest). The federal government, too, finds it difficult to rein in costs with efficiencies or promote innovative management. Yet Amazon, along with investor giant Berkshire Hathaway and JPMorgan Chase bank, announced Jan. 30 that they plan to provide “simplified, high-quality and transparent healthcare at a reasonable cost.”

These three corporate titans will first focus on their own employees, which number close to 1 million. But their ultimate goal is to show other companies how to bring higher productivity in health-care plans for their employees.

“Our group does not come to this problem [of ballooning costs] with answers,” said Berkshire chairman Warren Buffett. “But we also do not accept it as inevitable.”

Humility and hope are good starting points. Better technology and clever ideas may bring efficiencies to providers, such as hospitals and insurers. And employees can be better nudged to use the least-expensive health care or be given incentives to be healthy. But one big issue lies in defining the quality of care. Americans expect the best in treatments. And they have grown accustomed to letting others, for the most part, pay for it.

Rather than focus primarily on productivity, Amazon and its partners may want to take a cue about quality of care from Florence Nightingale, one of the biggest disrupters in the health-care industry. The 19th-century nursing pioneer raised the standards of health care by introducing many techniques. She helped launch a long tradition of innovation in medicine. Yet she also warned against those who would treat patients with the same efficiency that they would “take care of furniture, porcelain or even an animal.”

Nightingale’s greatest contribution may be in promoting the idea that health is not merely the absence of disease or infirmity. She focused more on the total well-being of a patient than the sickness. Attending to people’s biological needs should include attention to their mental, moral, social, and spiritual aspects with evidence-based practices. Over the past 150 years, that idea has steadily taken root, all the way up to the World Health Organization.

The best health-care providers, she advised, help patients rid themselves of apprehension and uncertainty. “How very little can be done under the spirit of fear,” she stated.

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These nonmedical aspects of health care are as worthy of attention from today’s innovators as other aspects of the industry. Healing is more than fixing the body. It also entails a wider view about quality of health.

The task of reducing health-care costs will be easier with a renewed focus on the overall well-being of patients. That’s the greatest lesson from one of the industry’s greatest disrupters.